1. Breast carcinoma in sclerosing adenosis: a clinicopathological and immunophenotypical analysis on 206 lesions.
- Author
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Yu BH, Tang SX, Xu XL, Cheng YF, Bi R, Shui RH, Tu XY, Lu HF, Zhou XY, and Yang WT
- Subjects
- Adult, Aged, Biomarkers, Tumor genetics, Biopsy, Breast Carcinoma In Situ genetics, Breast Carcinoma In Situ pathology, Breast Carcinoma In Situ surgery, Breast Neoplasms genetics, Breast Neoplasms pathology, Breast Neoplasms surgery, Carcinoma, Ductal, Breast genetics, Carcinoma, Ductal, Breast pathology, Carcinoma, Ductal, Breast surgery, Carcinoma, Intraductal, Noninfiltrating genetics, Carcinoma, Intraductal, Noninfiltrating pathology, Carcinoma, Intraductal, Noninfiltrating surgery, Carcinoma, Lobular genetics, Carcinoma, Lobular pathology, Carcinoma, Lobular surgery, Diagnostic Errors, Female, Fibrocystic Breast Disease genetics, Fibrocystic Breast Disease pathology, Fibrocystic Breast Disease surgery, Humans, In Situ Hybridization, Fluorescence, Middle Aged, Neoplasm Grading, Neoplasm Invasiveness, Phenotype, Predictive Value of Tests, Reproducibility of Results, Retrospective Studies, Tumor Burden, Biomarkers, Tumor analysis, Breast Carcinoma In Situ chemistry, Breast Neoplasms chemistry, Carcinoma, Ductal, Breast chemistry, Carcinoma, Intraductal, Noninfiltrating chemistry, Carcinoma, Lobular chemistry, Fibrocystic Breast Disease chemistry, Immunohistochemistry, Immunophenotyping methods, Sclerosis
- Abstract
Aims: To fully elucidate the clinicopathological features of breast carcinoma in sclerosing adenosis (SA-BC)., Methods: Clinical and histological characteristics of 206 SA-BCs from 180 patients were retrospectively evaluated. Immunohistochemical phenotype was examined. The clinicopathological relevance of the topographical pattern of SA-BCs was analysed., Results: Overall, up to 46 patients (25.6%) had contralateral cancer, either SA associated or not. Of 99 cases who underwent core needle biopsy (CNB), 36 were underestimated as adenosis or atypical ductal hyperplasia at CNB, 5 invasive cases were misinterpreted as in situ carcinomas, whereas 4 ductal carcinoma in situ (DCIS) cases were overdiagnosed as invasive carcinoma. Microscopically, 163 tumours were in situ, including 136 DCIS, 19 lobular carcinomas in situ (LCIS) and 8 mixed DCIS/LCIS; of these carcinomas in situ (CIS), 37 had microinvasion. The DCIS group exhibited low, intermediate and high grades in 53.7%, 34.6% and 11.8% of cases, respectively, mostly with solid (43.4%) or cribriform (41.9%) pattern. Forty out of 43 invasive cases were invasive ductal carcinoma (IDC), mostly DCIS predominant. Immunophenotypically, luminal A phenotype was identified in 55.1%, 63.2% and 45.0% of DCIS, LCIS and IDC cases, respectively. Topographical type A group (carcinoma being entirely confined to SA, n=176) was characterised by smaller size, less invasiveness, lower grade and more frequency of luminal A immunophenotype compared with type B group (≥ 50% but not all of the carcinomatous lesion being located in SA, n=30) (all P<0.05)., Conclusions: CIS, especially non-high-grade DCIS, represents the most common variant of SA-BC, and luminal A is the most predominant immunophenotype. CNB assessment might be challenging in some SA-BCs. The topographical pattern has great clinicopathological relevance. Careful evaluation of the contralateral breast and long-term follow-up for patients with SA-BC is necessary given its high prevalence of bilaterality., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
- Published
- 2018
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